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Obstructive sleep apnea syndrome (OSAS) in children is often caused by obstruction of the upper airway due to hypertrophy of the adenoids and palatine tonsils. Between October 1988 and December 1991, 50 children (34 males, 16 females) visited our department due to attacks of sleep apnea and underwent adenotomy or adeno-tonsillectomy. Respiratory monitoring during sleep was performed before and after operation, and the usefulness of the surgery was evaluated. Before operation, 27/ 50 children (54.0%) were diagnosed as having OSAS. Their age distribution showed peaks at the ages of 4 and 5 years and the male:female ratio was 2:1. Concerning the degree of improvement in clinical symptoms after surgery, marked effects were observed in 40/50 patients (80.0%), moderate effects in 7 (14.0%) and slight effects in 3 (6.0%). Concerning the degree of improvement in the apnea index after surgery in the 27 patients with OSAS, marked effects were observed in 22 patients (81.50%), moderate effects in 2 (7.4%), slight effects in 1 (3.7%) and no change in 2 (7.4%).